Premenstrual Dysphoric Disorder (PMDD)

What Is Premenstrual Dysphoric Disorder (PMDD)?

Premenstrual Dysphoric Disorder, also known as PMDD, is a hormone-related condition that affects mood, emotional regulation and physical well-being in the days or weeks leading up to a menstrual period. While many people notice premenstrual symptoms (PMS), PMDD is more intense and can feel deeply distressing, particularly when symptoms begin to interfere with your work, relationships or sense of emotional stability.

PMDD is thought to affect a smaller percentage of women of reproductive age, yet it is often underdiagnosed or misunderstood. This is partly because symptoms can overlap with anxiety, depression or other mood conditions and may change from one cycle to the next. For many people, recognising that these changes follow a cyclical pattern can help you make sense of what you’re experiencing and understand why symptoms may feel so disruptive.

Symptoms and What You May Notice

Symptoms of PMDD occur in the luteal phase of the menstrual cycle, typically after ovulation and before a period begins. These symptoms usually improve once menstruation starts.

You may notice changes such as:

• Physical symptoms such as bloating, breast tenderness or headaches
• Irritability, anger or emotional sensitivity
• Low mood or feelings of hopelessness
• Anxiety or feeling overwhelmed
• Difficulty concentrating or mental fog
• Fatigue or low energy
• Changes in sleep (insomnia) or appetite

Symptoms of PMDD can range from mild to severe and may interfere with work, relationships or your ability to feel like yourself. If several of these changes resonate, it may help to know that they can have a biological basis related to hormonal shifts across the menstrual cycle.

Causes and Underlying Factors

PMDD does not have a single cause. It is understood to involve an increased sensitivity to normal hormonal changes across the menstrual cycle, rather than a problem with hormone levels themselves. This means symptoms are not caused by “abnormal hormones” but by how the body and brain respond to natural changes.

Research suggests that in people with PMDD, fluctuations in hormones such as oestrogen and progesterone interact differently with brain chemistry, particularly neurotransmitters involved in mood regulation. While hormone levels are usually within a normal range, the brain’s response to these changes can be more pronounced, which may help explain the intensity of symptoms you experience.

This heightened sensitivity helps explain why PMDD symptoms often follow a predictable, cycle-related pattern and improve once menstruation begins. Understanding what’s happening in the body helps guide care that focuses on managing symptoms and supporting emotional and overall well-being.

Diagnosing PMDD

Understanding whether PMDD may be contributing to your symptoms takes time and careful assessment. Rather than relying on a single test, diagnosis focuses on recognising patterns in how symptoms change across the menstrual cycle and how they affect daily life.

A key part of assessment is identifying a consistent relationship between symptoms and the luteal phase of the cycle, the time after ovulation and before menstruation. Symptoms typically improve within a few days of a period starting. Tracking symptoms over at least two menstrual cycles is often recommended, as this can help clarify patterns that may not be obvious month to month. This can be done using a simple symptom diary or a tracking app.

Dr Peter’s assessment includes a detailed discussion of your symptoms, menstrual history, emotional wellbeing and overall health. Attention is given not only to what you’re experiencing, but also to how symptoms affect daily life, work and relationships.

Because PMDD symptoms can overlap with other mood, anxiety or medical conditions, it’s important to look at the whole picture. Conditions such as anxiety or depressive disorders, thyroid disease or other hormonal concerns may be considered. Where appropriate, blood tests or further investigations may be arranged to rule out other causes that could be contributing to symptoms.

This thoughtful approach helps ensure the assessment feels thorough and that care is tailored to what you’re experiencing, rather than based on a single test or label.

What to Expect in Your Appointment

Your appointment is a chance to talk through what you’ve been experiencing in a calm, supportive setting. Dr Peter will take time to understand the symptoms you’ve been experiencing, how they relate to your menstrual cycle and the impact they may be having on your mood, relationships and daily life.

The consultation typically includes a detailed discussion of symptom timing, emotional changes, menstrual patterns and overall health. Previous assessments or treatments are reviewed and where helpful, symptom tracking or further assessment may be recommended to clarify patterns and guide care.

Following the assessment, Dr Peter will talk through the findings with you and explain the available management options. You’ll have space to ask questions and discuss any concerns. Follow-up appointments may be recommended to review progress, adjust care or monitor symptoms over time. The aim is for you to leave feeling understood, supported and clear about the next steps.

Why Choose Dr Peter Jurcevic

Living with PMDD can be exhausting and isolating, particularly when mood and physical symptoms disrupt your sense of stability or affect relationships and daily life. Choosing the right specialist matters in these moments. Dr Peter understands that PMDD symptoms are real, distressing and not something you can simply push through. He takes time to listen carefully, without judgement and to understand how symptoms affect you personally, across your cycle and in everyday life.

Patients often appreciate Dr Peter’s calm and thoughtful approach, as well as his clear communication. Care is approached thoughtfully, with management plans shaped around your symptoms, priorities and what feels manageable for you at this stage.

Where appropriate, Dr Peter works closely with your General Practitioner and other healthcare providers to ensure care feels supported, coordinated and responsive as your needs change over time. If you would like to discuss your concerns or explore whether an appointment may be helpful, support is available.